Helping the uninsured navigate health care purchase

Less than 6 months before open enrollment for subsidized insurance, 2 Illinois insurers have launched campaigns to educate potential beneficiaries

April 15, 2013|By Peter Frost, Chicago Tribune reporter

Dr. Martha Perez examines Maria Lebron in a room at the Community Health of South Florida, Doris Ison Health Center on February 21, 2013 in Miami, Florida. Florida Gov. Rick Scott reversed himself on February 20, and now is calling for an expansion of Medicaid to Florida residents under the federal Affordable Care Act. (Joe Raedle)

Less than six months remain before nearly 1 million Illinoisans can begin signing up for subsidized health insurance, the first major step in kicking off the most ambitious overhaul of the nation's health care system in a generation.

Yet not nearly enough of those eligible to receive government assistance to buy health coverage — a key provision in President Barack Obama's sweeping health care overhaul law — know anything about it.

While both Illinois and the federal government plan a marketing blast to introduce the program to consumers, the brunt of that effort will not arrive until summer.

That leaves many unsure and unaware of the benefits they may be eligible to receive starting in 2014 or the penalties they'll have to pay if they don't get coverage.

With open enrollment scheduled to begin Oct. 1, at least two Illinois insurers have quietly stepped into the void, launching outreach and educational campaigns to bring unknowing beneficiaries up to speed.

"To reach and process so many people in that relatively short amount of time is going to be a phenomenal challenge," said Ceci Connolly, managing director of PricewaterhouseCoopers' Health Research Institute. "We think it's absolutely critical that (insurers' educational efforts) begin now."

Blue Cross and Blue Shield of Illinois, the state's largest insurer in terms of market share, and Land of Lincoln Health, one of 24 new health insurance cooperatives approved by the federal government, began educational campaigns in recent weeks targeting consumers who will be eligible to receive a federal tax credit to buy coverage.

They're partnering with community groups, schools, churches and other organizations to make inroads into pockets of populations most likely to qualify for benefits, including low-income and immigrant households, many of which may never have had health coverage.

Blue Cross this month launched an educational website, becoveredillinois.org, and has participated in events at a West Side church with Rep. Danny Davis and at a large Latino family festival at the University of Illinois at Chicago.

"There's a lot of misinformation, misunderstanding and a lot of naivete about insurance in general," said Karen Atwood, president of Blue Cross and Blue Shield of Illinois. "As we contemplated the exchanges and open enrollment, we found there is a huge need for additional education in the marketplace."

With many of those eligible for the new benefits unaware of basic things such as how to access a primary care doctor, helping them understand the nuances of the highly complex overhaul law and its effect on them "is a heavy lift," Atwood said.

The insurer said its outreach efforts will likely cost "millions of dollars," including distributing brochures and fliers at community forums, festivals, health fairs and other cultural events.

That effort could be rewarded down the line after it pivots to marketing the plans it will offer on the exchange, leveraging the brand recognition and goodwill accumulated during months of being in front of consumers with initial outreach initiatives.

"The motivation for (insurers) to start now is to get ahead of the game and get as much enrollment in their plans as possible," said Matt Amodeo, an Albany, N.Y.-based attorney with Drinker Biddle & Reath who counts several insurance companies as clients. "The larger population they insure, the greater population on which to spread the risk and presumably the more money they'll make on the business."

Americans who make between 138 percent and 400 percent of the federal poverty line — $15,856 to $45,960 for individuals — will be eligible for a government tax credit to help offset the cost of buying health insurance. The amount of the subsidy varies based on income.

Those who are not eligible for Medicare or Medicaid and do not receive coverage from their employers will be subject to a penalty, which starts off relatively modest but increases in future years.

The penalty was devised to encourage more young healthy people, such as the "young invincibles," into the insurance pool to help subsidize the higher costs incurred by sicker people who cost insurers the most money.

A portion of the 45 million-plus Americans who don't today carry health insurance are young adults who avoid the expense of health insurance because they don't think they'll get sick or need medical treatment.

If a sizable group of healthier people don't sign up, insurers are at risk of losing money. That's why drawing them into the exchanges is a critical goal of the outreach programs launched by Blue Cross and Land of Lincoln.

"For us, we need to remain sustainable, so it does matter in that regard," said Daniel Yunker, CEO of Land of Lincoln, a nonprofit that was formed last year under a new category of carriers called Consumer Operated and Oriented Plans, or "co-ops."